HomeMy WebLinkAboutR 2018-413 Finance - Duke Home and Hospice Care outside agency agreement(Duke HomeCare & Hospice)
Orange County Outside Agency Performance Agreement Page 6 of 9
Rev. 7/18
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Duke HomeCare & Hospice Party/Vendor Contact Person: Kevin Carter Contact Phone: 919-
479-0318 Party/Vendor Address: 4321 Medical Park Drive, Suite 101 City Durham State: NC Zip: 27704
Department: Finance & Administrative Services Amount: 1115 Purpose: FY 2018-19 Outside Agency/Human
Services Performance Agreeement Budget Code(s): 10495050-710026 Vendor # 50707 (N/A if new vendor)
Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment
Effective Date 7/1/2018 Approved by Board Yes No Agenda Date: 6/19/2018
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion @ singersoll@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: E8DFACF7-45BE-435E-9B5A-BB177E968F07